The Role of Chiropractic as We Approach the Year 2000 and Beyond

by Chester Wilk, DC

When we ask ourselves what role chiropractors should play in the coming
years, it evokes a wide variety of answers. Although there are many vital
roles to consider, we'd be hard-pressed to exclude any or choose one over
the other among those listed below. Let's discuss each of them.

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Preserve the Unique Identity of Chiropractic

Chiropractors have established themselves as drugless physicians who rely primarily
on spinal adjusting as their treatment, to improve the quality of life of
the patient by assisting the body to heal and maintain itself in a good
state of health. Whatever supportive measures we utilize toward this goal,
they are secondary to spinal adjusting. We are structural biomechanics.
It's an identity that is viewed with envy by other members of the health
care professions, who would like to enjoy this image much that some even
try to emulate spinal adjusting. We not only need to preserve our unique
identity for future generations of chiropractors, but need to reinforce
it by continuing to be the very best that we can be as physicians who adjust
the spine.

Preserve the Scope of Practice

Some chiropractors are willing to compromise the scope of chiropractic by limiting themselves
to the care of low-back pain and headaches. They may do it to avoid the criticism of "playing
it safe" and confining themselves to ailments where chiropractic dramatically excels with
clinically-based outcome studies. However, we cannot limit chiropractic to such a narrow role,
because it is not a scientifically correct posture to close doors on research without evaluating and
determining the real potential of any treatment.

We need to accurately define our role in health care without creating
public confusion or criticism. The best way is to clarify that we do not
treat ailments in the usual sense, but that we treat patients for their
ailments, and that our scope can vary from patient to patient, from ailment
to ailment, and from time to time. We help the patient's body to help
itself. This is not splitting hairs or being evasive; we simply cannot
be more specific. This approach explains our scope of health care in a
logical and reasonable manner that no objective observer can fault, and
is acceptable to the scientific community and the courts. By following
this approach we will not close any doors on the potential of chiropractic
health care, which will prevent our adversaries from claiming with any
credibility that we overstep our limits in treating patients.

Maintain a Rational Balance in Health Care

The pharmaceutical industry spends a billion dollars a month advertising and promoting drugs.
Our society is overmedicated and overoperated on. There are 80,000 unnecessary disc surgeries
being performed annually, according to "CBS News." A Yale New Haven Hospital Study found
that 100,000 people die annually from medication reactions, while other studies say that this«
a thousand people die every week from unnecessary surgery. We see medical/surgical promotion
too often take precedence over objectivity and balance. Major national publications have written
articles on how medicine is losing the battle against bacteria because they mutate and become
more resistant to antibiotics. It is especially irresponsible when they are used on patients with
viral conditions, since antibiotics are medically proven to be ineffective against viruses.

There are tissue-eating bacteria afflicting our society today for which there is only one known
antibiotic capable of killing them. What will happen if these bacteria mutate and become
resistant to the only remaining antibiotic? Medical treatments are creating a serious
doctor-caused crisis. We need to stress improving the quality of life and the natural resistance
of the human body through chiropractic care, which eliminates the potential of bacterial
mutation and iatrogenic reactions.

Chiropractors have a major responsibility to help our society maintain some semblance of a
rational balance and objectivity in health care. I cringe whenever I hear a chiropractor suggest
that we should incorporate drugs into chiropractic. Not only would this dilute and undermine
the basic principle of chiropractic health care, but it would represent a major step backward for
rational health care in a society that is already overmedicated and overoperated.

Chiropractors are not opposed to the rational use of drugs, but have spoken out against excessive
and abusive overutilization. For this reason, we have been accused of opposing drugs in general.
Most of us agree that drugs have their place, but not within chiropractic. The American people
need the check and balance that the chiropractic profession provides with diversity and
competition, which enhances the quality of health care while lowering its cost.

Osteopathy has suffered after incorporating drugs into its curriculum.
Moreover, society has suffered by a less-balanced health care system.
Not long ago, some osteopathic schools actually abandoned spinal manipulation
by making it an elective subject. I visited an osteopathic school, and
the attitude I saw exhibited by the osteopaths and their patients could
not approach the enthusiasm I have seen in chiropractic colleges. The
osteopathic school appeared depressed and run by frustrated medical wannabes.
We have a wonderful profession in chiropractic, but we need to keep it
drugless and oriented on spinal adjustment. This is where we get our real
strength and unique identity.

Our Role as Physician, Teacher and Educator

A physician is a teacher in the finest sense of the word, and it is imperative
that chiropractors assertively embrace this role. While medical doctors
benefit from a billion-dollar-a-month pharmaceutical advertising campaign,
the chiropractic profession is not privy to such extravagant promotion.
We are the only ones who can accurately and effectively promote chiropractic
and level the playing field in health care. While it is true that medicine
has the advantage of big money promoting it, we have something far more
important--we have truth on our side!

I doubt that we can find one chiropractor out of a hundred who will agree
that our current health care system is being practiced in a completely
honest, objective and well-balanced manner in America. How can it be?
A U.S. government study using two hundred of our nation's leading pain,
then published guidelines urging all physicians to refer patients for
spinal manipulation as the best treatment for many of these ailments.
Yet four months later, the AMA published its own so-called guidelines/treatment
options for low-back pain, which excluded any reference to spinal manipulation!
Something is extremely wrong with this scenario.

In my opinion this is fraud by omission, exclusion, isolation and polarization. I showed these
facts to numerous lawyers, and all of them felt that my position had genuine merit. You can
call it what you want, but in my opinion it is plainly fraud. Furthermore, the impressive
findings of the U.S. government study by the Agency for Health Care Policy and Research are
reinforced by government studies from Canada, Great Britain, and New Zealand. Apparently
all of this overwhelming clinical evidence means nothing to the closed-minded policies of the
AMA, which may end up injuring patients.

We need to tell it like it is when we see wrong being committed, but
we also need to educate the public on what is right and what role chiropractic
must play in the years to come. It is our moral and ethical obligation
as physicians and teachers.

The Role of Science in Chiropractic

Western civilization requires that every health care profession be committed to
establishing a scientific basis for its existence. Certainly chiropractic
is no exception, yet we need to recognize that science is not synonymous
with truth; it is no more than an effort to find the truth. For example,
science "proved" that the C-123 transport jet would not be able to get off
the ground and fly. Indeed, it not only flies but can carry tanks and trucks.
It would be absurd to suggest that the plane cannot fly if you see it in
the sky overhead. Too many critics of chiropractic refuse to look at the
obvious. It would be equally absurd to deny the results of scientifically
controlled clinical outcome studies of any treatment that science cannot
totally explain. We must acknowledge and respect the fact that it works
and then strive to explain why. This is what is meant when they say that
technology precedes science.

The Role of Champions of Truth and Objectivity in Health Care

On the surface it would appear that this honorable and altruistic role is quite easy. After all, all
we have to do is just candidly speak out the truth. In fact, it is one of the most difficult and
challenging roles to attain and maintain. It takes a special kind of courage and commitment to
be totally truthful. Honest critics will often be attacked and vilified. Our adversaries may say
that our criticism is "the same old chiropractic versus medicine" controversy and will obfuscate
the truth by saying we are "bashing" or being hostile, divisive and uncooperative. To some
doctors, cooperating and working together means looking the other way when they do something
stupid or dishonest. It's not an easy position to take, but we must do it, for the sake of our
patients and to do what we know is right.

To prevail in this matter, the public needs to hear the same message
repeated from hundreds of different sources until it becomes accepted
by the public. There is actual truth and then there is what the public
perceives as the truth. Too often, physicians choose to take the easy
way out Championing the truth is a two-way street. It also means being
truthful to ourselves. We cannot be critical of medical abuses while looking
the other way if our own members conduct themselves dishonestly. We have
a fine code of ethics and need to see that it is honestly observed by
our members. Nothing can devastate a profession more lethally than if
its members allow it to decay from within. We need to assertively and
willingly cooperate with any state and federal authorities to see that
our members conduct themselves in an honest and honorable manner deserving
of our profession.

It takes courage and wisdom to acknowledge to ourselves when we make mistakes (and we all
do), yet we will be doomed to repeat these mistakes over and over again if we don't face up to
them, and when we do we will always make them for the first time. As the old saying goes, we
either learn from our past mistakes in history or we are doomed to repeat them.

The many positive facts that we have going for chiropractic combined with the disgraceful
polarization we see in health care are so unbelievable and outrageous at times that many people
will have a difficulty in accepting them as factual, especially when our society has been heavily
programmed toward drugs and surgery. How can we address and prevail in this challenge?

This can be accomplished by the formation of chiropractic speaker bureaus
in every state, making them the single most important project in each
state, recruiting chiropractors and training them on how to approach and
effectively communicate to the media, and speak repetition, a high profile
and the same message coming from hundreds of different sources are the
real keys to success. The impact it can have on every chiropractic practice
from a standpoint of insurance relations, legislation and public opinion
and acceptance can be profound. The speaker bureau program can become
the hub that addresses and corrects many of the problems facing chiropractic
for decades. This is the only cost-effective and logical approach that
can level the playing field. And lest we forget, we have the most potent
weapon of all. It is called truth!
We just need a delivery system for this truth and speaker bureaus in every
state provide the answer.

The Role Model in Health Care

What the chiropractic profession has been able to accomplish with its magnificent college
facilities (appraised by a leading medical expert as superior to medical schools), its clinical and
scientific research projects (in spite of neglect by the same agencies that give billions to medical
research), our fine quality of care and standard of care guidelines, and our code of ethics
guidelines, reflect a strong commitment to excellence. These accomplishments are truly
inspirational. We have often been our own toughest critics, which speaks all the more of our
dedication to excellence. I don't know of any group of healers who have accomplished more
and fought more heroically to prove to the world that they are worthy of serious consideration
and respect as healers. This is not to say that we are perfect, but we certainly have earned some
real respect and bragging rights.

The chiropractic profession is a great role model that has shown to the world what can be
accomplished by its commitment to excellence. Adversity often makes people rise to the«
Chiropractic is truly more than a health care profession that works in harmony with everyone
it touches; it is a magnificent way of life. The public needs to know this truth, and we need to
make them aware of it.